脉搏指示连续心排血量监测对重症急性胰腺炎患者的干预效果

Interventional Effect of Continuous Monitoring of Pulse Indicating Cardiac Output on Patients with Severe Acute Pancreatitis

目的探讨脉搏指示连续心排血量监测对重症急性胰腺炎患者的干预效果。方法回顾性分析2018年1月至2019年1月福建医科大学附属漳州市医院收治的70例重症急性胰腺炎患者的临床资料,根据监测方式的不同分为对照组和试验组,每组35例。对照组采用中心静脉压监测,试验组采用脉搏指示连续心排血量监测,比较两组复苏液体量及急性生理及慢性健康状况评分Ⅱ(APACHEⅡ)。结果两组0~24 h的复苏液体量比较,差异无统计学意义(P>0.05);试验组25~48、49~72 h的复苏液体量均少于对照组,差异均有统计学意义(P<0.05);试验组复苏24、48 h的APACHEⅡ评分均低于对照组,差异均有统计学意义(P<0.05)。结论脉搏指示连续心排血量监测可帮助重症急性胰腺炎患者更安全地进行液体容量复苏,改善组织灌注,降低治疗风险,合理控制复苏液体量,进而提升治疗效果。

Objective To investigate the intervention effect of continuous monitoring of cardiac output with pulse indication on patients with severe acute pancreatitis.Methods The clinical data of 70 patients with severe acute pancreatitis admitted in Zhangzhou Hospital Affiliated to Fujian Medical University from January 2018 to January 2019 were analyzed retrospectively.According to the different monitoring methods,the patients were divided into the control group and the observation group,35 cases in each group.The control group were treated with central venous pressure monitoring,and the observation group were treated with pulse indicating continuous cardiac output monitoring.The volume of resuscitated fluid,acute physiology and chronic health score(APACHEⅡ)were compared between the two groups.Results There was no significant difference between the two groups in the volume of resuscitated liquid within 0~24 h(P>0.05);the volume of resuscitated liquid within 24~48 h and 48~72 h in the observation group were lower than those in the control group(P<0.05).The APACHEⅡscore at 24 h and 48 h in the observation group were lower than those in the control group(P<0.05).Conclusion Continuous monitoring of cardiac output with pulse indication can help patients with severe pancreatitis to carry out fluid volume resuscitation more safely,improve tissue perfusion,reduce the risk of treatment,and reasonably control the volume of resuscitated fluid,improve the curative effect.